Physicochemical properties of flowable composites using isobornyl methacrylate as diluent monomer.

OBJECTIVE: this study sought to evaluate the effect of isobornyl methacrylate (IBOMA) as a diluent monomer on the physicochemical properties of experimental flowable resin composites. METHODOLOGY: the organic resin matrix of a modal flowable resin composite was formulated with 50 wt.% of bisphenol-A-glycidyl methacrylate (Bis-GMA) and 50 wt.% of a diluent monomer, in which IBOMA was used as a combining or substituent diluent monomer to triethylene glycol dimethacrylate (TEGDMA). The resin matrices were filled with 55 wt.% particles, of which 10 wt.% was 0.05-µm fumed silica, and 45 wt.% was 0.7-µm BaBSiO2 glass. Polymerization shrinkage stress (PSS; n=10), degree of conversion (DC; n=3), maximum rate of polymerization (Rpmax; n=3), film thickness (FT; n=10), sorption (Wsp; n=10), solubility (Wsl; n=10), flexural strength (FS; n=10), flexural modulus (FM; n=10), Knoop microhardness (KH; n=10), and microhardness reduction after chemical softening (HR; n=10) were evaluated. Data were analyzed using one-way ANOVA, followed by Tukey's test (α=0.05; ß=0.2). RESULTS: the results showed that the substitution or addition of IBOMA reduced FT (p=0.001), PSS (p=0.013), Rpmax (p=0.001), DC (p=0.001), FM (p=0.006) Wsp (p=0.032), and Wsl (p=0.021). However, when used as a complete substituent, IBOMA demonstrated significantly lower FS (p=0.017) and KH (p=0.008), while TEGDMA demonstrated significantly lower HR (p=0.022). CONCLUSION: the flowable composite containing IBOMA combined with TEGDMA showed no effect in KH and FS and effectively reduced the PSS, RP, FT, Wsp, and Wsl. However, it showed a reduction in DC, FS, and an increase in HR.

Effect of adding arginine at different concentrations to experimental orthodontic resins: an in vitro study.

The aim of this study was to assess the effect of adding arginine at different concentrations to commercial and experimental orthodontic resins on shear bond strength (SBS), as well as on the antimicrobial activity of arginine against S. mutans. Metal brackets were bonded onto the surface of 120 bovine incisors using Transbond, OrthoCem, and an experimental resin (ER), adding 0, 2.5, 5, and 7 wt.% of arginine. The SBS test was performed in deionized water at 37 ºC for 24 h, at 0.5 mm/min. SBS test results were subjected to two-way ANOVA and Tukey's test (α = 0.05). CFU/mL data (antimicrobial assessment) were assessed by Kruskal-Wallis and Dunn's tests (α = 0.05). No statistical difference between the resins was observed in untreated groups (p > 0.05). The addition of arginine at 2.5% (27.7 MPa) and 5% (29.0 MPa) increased the SBS of Transbond when compared (p < 0.05) to OrthoCem (18.5 and 15.6 MPa, respectively) and ER (16.3 and 18.1 MPa, respectively). Arginine at 7% improved the SBS of Transbond (24.1 MPa) and ER (21.0 MPa), which was statistically higher (p < 0.05) than OrthoCem (12.6 MPa). OrthoCem did not show a statistically significant difference at the three concentrations of arginine (p > 0.05). The addition of arginine to resins reduced the count of S. mutans (p < 0.05). As for ER, all concentrations of arginine significantly decreased CFU/mL (p < 0.05). Among commercial resins, only 7% of arginine significantly reduced CFU/mL. The addition of arginine did not interfere with the bond strength and demonstrated antibacterial activity against S. mutans.

Effect of Radiotherapy on the Adhesive Interface of Caries-affected Dentin and Bioactive Restorations: A Micro-CT Analysis.

PURPOSE: This study aimed to analyze the presence of defects within the adhesive interface formed with five bioactive dental materials and caries-affected dentin concerning the timing of radiotherapy (before or after the restorative procedures) by micro-CT. METHODS AND MATERIALS: A total of 96 carious human molars were randomly allocated into the following groups based on the timing of the radiotherapy sequence: radiotherapy followed by restoration (RT1) or restoration followed by radiotherapy (RT2). Then, six subgroups were established within these groups based on the type of materials used (n=8). Following cavity preparation and caries removal, a universal adhesive (G-Premio Bond) was administered in self-etch mode or accompanied by applying suitable cavity conditioners according to the manufacturers' guidelines. Subsequently, restorations were performed using five bioactive restorative materials (resin-modified glass-ionomer [Fuji II LC], high-viscosity glass-ionomer hybrid [EQUIA Forte HT], giomer [Beautifil II], alkasite [Cention N], and dual-cure bulk-fill composite [Activa Bioactive Restorative]) and a conventional microhybrid resin composite (Filtek Z250). The radiotherapy regimen encompassed 60 Grays (Gy) administered at a rate of 2 Gy/day over 6 weeks, 5 days a week. Micro-CT analysis was employed to assess adhesive defects at the interface between caries-affected dentin and the restorations. The data were analyzed using Kruskal-Wallis, Mann-Whitney U, and Dunn tests (α=0.05). RESULTS: RT2 caused significantly higher adhesive defects than RT1 for the Filtek Z250 and Activa Bioactive Restorative subgroups (p<0.05). For RT1, no significant differences were found in adhesive defects among all tested subgroups (p>0.05). By contrast, for RT2, adhesive defects were significantly higher for the Activa Bioactive Restorative and Cention N subgroups than for the EQUIA Forte HT and Beautifil II subgroups (p<0.05). CONCLUSIONS: When using most bioactive restorative materials, the timing of radiotherapy had no significant influence on the adhesive interface. Regarding restoration following a radiotherapy protocol, a favorable impact was identified with high-viscosity glass ionomer hybrid cement and giomer bioactive restorations compared with dual-cure bioactive bulk-fill composite and alkasite restorations.

Surface roughness of different types of resin composites after artificial aging procedures: an in vitro study.

BACKGROUND: The temperature changes, chemical agents, and brushing activity that resin composite restorations are exposed to in the oral environment can cause changes in surface roughness. In this study, the aim was to investigate in vitro the clinical one-year surface roughness changes of different types of composites (flowable or conventional) from the same companies by subjecting them to immersion in solutions, brushing, and thermal cycling procedures to simulate intraoral conditions. METHODS: Four different resin composite brands were included in the study using both their conventional (Charisma Smart, 3M Filtek Ultimate Universal, Omnichroma, Beautifil II) and flowable resin composites (Charisma Flow, 3M Filtek Ultimate Flowable, Omnichroma Flow, Beautifil Flow Plus F00), giving 4 groups with 2 types of resin composite in each. 40 samples were prepared for each group/resin type, for a total of 320 samples. After initial surface roughness measurements by a mechanical profilometer, the samples were divided into 4 subgroups (n = 10) and immersed in solutions (distilled water, tea, coffee, or wine) for 12 days. The samples were then subjected to 10,000 cycles of brushing simulation and 10,000 cycles of thermal aging. Surface roughness measurements were repeated after the procedures. For statistical analysis, the 3-way analysis of variance and the Tukey test were used (p < 0.05). RESULTS: It was concluded that composite groups and types had an effect on surface roughness at time t0 (p < 0.001). At time t1, the highest surface roughness value was obtained in the Beautifil-conventional interaction. When the surface roughness values between time t0 and t1 were compared, an increase was observed in the Beautifil II and Beautifil Flow Plus F00, while a decrease was observed in the other composite groups. CONCLUSION: Composite groups, types, and solutions had an effect on the surface roughness of resin composites. After aging procedures, it was concluded that the Beautifil group could not maintain the surface structure as it exceeded the threshold value of 0.2 µm for bacterial adhesion.

Comparative Evaluation of Microtensile Dentin Bond Strength and Interfacial Micromorphology of Three Universal Adhesives.

OBJECTIVES: To assess and compare the microtensile dentin bond strength (µTBS) and interfacial micromorphology of three universal adhesives. METHODS: 96 human molars were assigned to three universal adhesives: Single Bond Universal (SBU), CLEARFIL Universal Bond Quick (UBQ), and RE-GEN Universal Adhesive (REGEN). Adhesives were applied in self-etch mode. SBU and REGEN were applied following the manufacturers' instructions. UBQ was divided into two subgroups: one following the manufacturer's instructions (UBQ Short) and the other with an extended application time (UBQ Extended). Teeth were restored with nanohybrid resin composite. Specimens were divided into immediate and delayed subgroups. The delayed subgroups were stored for 6 months and subjected to 5000 thermocycles. µTBS was tested, and failure mode was analyzed. Interfacial micromorphology was assessed using a scanning electron microscope. The data were statistically analyzed (p⟨ 0.05). RESULTS: The adhesive choice, aging, and their interaction significantly affected µTBS. SBU exhibited the highest immediate µTBS, comparable to UBQ (Extended) and REGEN, and significantly higher than UBQ (Short). In delayed testing, SBU outperformed the other adhesives. CONCLUSIONS: Aging negatively affected the µTBS of UBQ and REGEN, while SBU wasn't affected. The quick application concept of UBQ deteriorated its µTBS compared to the extended application time.

Physicochemical characterization of experimental resin-based materials containing calcium orthophosphates or calcium silicate.

OBJECTIVE: To evaluate experimental dimethacrylate-based materials containing calcium orthophosphates or calcium silicate particles in terms of their optical, mechanical and Ca2+ release behaviour. METHODS: Dicalcium phosphate dihydrate (DCPD), hydroxyapatite (HAp), beta-tricalcium phosphate (ß-TCP) or calcium silicate (CaSi) particles were added to a photocurable BisGMA/TEGDMA resin (1:1 in mols) at a 30 vol% fraction. Materials containing silanized or non-silanized barium glass particles were used as controls. Degree of conversion (DC) at the top and base of 2-mm thick specimens was determined by ATR-FTIR spectroscopy (n = 5). Translucency parameter (TP) and transmittance (%T) were determined using a spectrophotometer (n = 3). Biaxial flexural strength (BFS) and flexural modulus (FM) were determined by biaxial flexural testing after 24 h storage in water (n = 10). Ca2+ release in water was determined during 28 days by inductively coupled plasma optical emission spectrometry (n = 3). Statistical analysis was performed using ANOVA/Tukey test (DC: two-way; TP, %T; BFS and FM: one-way; Ca2+ release: repeated measures two-way, α = 5 %). RESULTS: CaSi and ß-TCP particles drastically reduced DC at 2 mm, TP and %T (p < 0.001). Compared to both controls, all Ca2+-releasing materials presented lower BFS (p < 0.001) and only the material with DCPD showed significantly lower FM (p < 0.05). The material containing CaSi presented the highest Ca2+ release, while among materials formulated with calcium orthophosphates the use of DCPD resulted in the highest release (p < 0.001). SIGNIFICANCE: CaSi particles allowed the highest Ca2+ release. Notwithstanding, the use of DCPD resulted in a material with the best compromise between optical behaviour, DC, strength and Ca2+ release.

Bis-EMA/Bis-GMA ratio effects on resin-properties and impregnated fiber-bundles.

OBJECTIVES: To evaluate the effect of different ratios of Bis-EMA/Bis-GMA resin mixtures on the inherent viscosity and curing-related properties: including degree of cure (DC%), shrinkage strain, Knoop micro-hardness (KH) and flexural strength of resin-impregnated fiber-bundles. METHODS: Bis-EMA/Bis-GMA monomers were mixed (by weight) in the following ratios: M1 = 30 %/70 %, M2 = 50 %/50 %, M3 = 70 %/30 %, and M4 = 100 %/0 %. Standard measurements were made of refractive index, viscosity, degree of conversion, shrinkage strain and Knoop hardness (KHN). For 60 % glass fiber-bundles impregnated with 40 % resin, three-point bending test for flexural strength and shrinkage strain were measured. Data were analyzed by One-way ANOVA and Bonferroni post-hoc tests (α = 0.05). RESULTS: For resin mixtures, increasing Bis-EMA proportion decreased refractive index (p < 0.05), and viscosity (p < 0.05), and increased monomer conversion (DC%), shrinkage strain and KHN (p < 0.05). DC% increased after 1 h for all resin mixtures. The shrinkage strain and flexural strength of resin-impregnated fiber-bundles reduced with increased Bis-EMA. SIGNIFICANCE: Monomeric mixtures with highest amounts of Bis-EMA showed enhancement in several clinically-relevant properties and polymerization of respective resin-impregnated glass fibers. This makes them potential candidates for impregnating glass fibers in fiber-reinforced restorations.

Effect of Different Adhesive Resin and Composite Veneering Materials on Adhesion to Polyetheretherketone.

OBJECTIVE: To evaluate the effect of different adhesives and veneering resins on the shear bond strength (SBS) of polyetheretherketone (PEEK). METHODS: A total of 138 PEEK specimens were randomly divided into 6 groups according to adhesive material application: Control (C, no application), Adhese Universal (A) (Ivoclar Vivadent, Schaan, Liechtenstein), Gluma Bond Universal (G) (Heraeus Kulzer, South Bend, IN, USA), G-PremioBOND (P) (GC Corporation, Tokyo, Japan), Single Bond Universal (S) (3M, Saint Paul, MN, USA) and visio.link (V) (Bredent, Senden, Germany). Each adhesive group was divided into two subgroups according to the type of veneering material: Estenia direct composite (D) and Gradia Plus indirect composite (IN) (both GC Corporation). After the veneering process, the specimens were aged by thermal cycling. Kruskal-Wallis and Mann-Whitney U tests were used for SBS analysis (P < 0.05). RESULTS: The highest SBS results were obtained in the VIN group, followed by the VD, PD, GIN, AIN, AD, SIN, SD, PIN, GD, CIN and CD groups, respectively (P = 0.001). There were no significant differences in terms of the type of veneering composite when the same adhesive was applied (P > 0.05), except for Gluma Bond Universal (P = 0.009). All the adhesives tested showed clinically acceptable SBS results. CONCLUSION: Visio.link offered the highest adhesion to PEEK, whereas the tested universal adhesives may be used as an alternative to visio.link in clinical settings. It was determined that changing the veneer type has no statistical difference when the same adhesive material is used.

Light-curable urushiol enhanced bisphenol A glycidyl dimethacrylate dentin bonding agent.

OBJECTIVES: The low durability of composite resin restorations can be attributed to the degradation of the resin dentin bonding interface. Owing to the presence of hydrophilic components in the adhesive, the integrity of the resin dentin bonding interface is easily compromised, which, in turn, leads to a reduction in bond strength. The hydrophilic nature of the adhesive leads to water sorption, phase separation, and leaching of the resin component. Therefore, hydrophobic adhesives could effectively be used to stabilize the integrity and durability of the resin dentin bonding interface. METHODS: We synthesized a novel hydrophobic dentin adhesive by partially replacing bisphenol A glycidyl dimethacrylate (Bis-GMA) with a light-curable urushiol monomer. The properties of the produced adhesive, including the degree of conversion, viscosity, contact angle, water sorption/solubility, and mechanical strength, were comprehensively examined and compared to those of the commercially adhesive Adper Single Bond2 as a positive control. The adhesive properties were determined using microtensile bond strength measurements, laser confocal microscopy, scanning electron microscopy observations, and nanoleakage tests. Finally, the novel adhesive was subjected to biocompatibility testing to determine its potential cytotoxicity. RESULTS: At a light-curable urushiol content of 20 %, the synthesized adhesive exhibited high degrees of conversion and hydrophobicity, low cytotoxicity, good mechanical properties, and outstanding adhesive strength. CONCLUSIONS: The introduction of the light-curable urushiol into dentin adhesives can significantly enhance their hydrophobic, mechanical, and bonding properties, demonstrating potential to significantly improve restoration longevity. CLINICAL SIGNIFICANCE: The integration of light-curable urushiol has endowed the experimental adhesives with several enhanced functionalities. These notable benefits underscore the suitability of this monomer for expanded applications in clinical practice.

Engineering Interfacial Integrity with Hydrolytic-Resistant, Self-Reinforcing Dentin Adhesive.

The leading cause of composite restoration failure is secondary caries, and although caries is a multifactorial problem, weak, damage-prone adhesives play a pivotal role in the high susceptibility of composite restorations to secondary caries. Our group has developed synthetic resins that capitalize on free-radical polymerization and sol-gel reactions to provide dental adhesives with enhanced properties. The resins contain γ-methacryloxypropyltrimethoxysilane (MPS) as the Si-based compound. This study investigated the properties of methacrylate-based resins containing methacryloxymethyltrimethoxysilane (MMeS) as a short-chain alternative. The degree of conversion (DC), polymerization kinetics, water sorption, mechanical properties, and leachates of MMeS- and MPS-resins with 55 and 30 wt% BisGMA-crosslinker were determined. The formulations were used as model adhesives, and the adhesive/dentin (a/d) interfaces were analyzed using chemometrics-assisted micro-Raman spectroscopy. The properties of the 55 wt% formulations were comparable. In the 30 wt% BisGMA formulations, the MMeS-resin exhibited faster polymerization, lower DC, reduced leachates, and increased storage and loss moduli, glass transition (Tg), crosslink density, and heterogeneity. The spectroscopic results indicated a comparable spatial distribution of resin, mineralized, and demineralized dentin across the a/d interfaces. The hydrolytically stable experimental short-chain-silane-monomer dental adhesive provides enhanced mechanical properties through autonomous strengthening and offers a promising strategy for the development of restorative dental materials with extended service life.

New Monomer Capable of Dual Chemical Binding with Dentin to Improve Bonding Durability.

The water-rich nature of the dentin bonding microenvironment, coupled with the stresses on the bonding interface, contributes to the hydrolytic degradation of the hybrid layer, resulting in a decline in bonding durability and, ultimately, restoration failure. Currently, the 3-step etch-and-rinse technique remains the gold standard for dentin bonding, and the bonding mechanism mainly involves a physical interaction with little chemical bonding. In this study, we have developed a siloxane-modified polyurethane monomer (SPU) with acrylate and siloxane modifications that chemically binds to both collagen and hydroxyapatite in dentin. Formulated as a bisphenol A-glycidyl methacrylate alternative, the SPU monomer-based adhesive was designed to improve dentin bonding quality and durability. Attenuated total reflection Fourier transform infrared spectroscopy, thermogravimetric analysis, X-ray photoelectron spectroscopy, scanning electron microscopy, transmission electron microscope, and hydroxyproline release assays were performed on SPU-treated collagen, hydroxyapatite, and acid-etched dentin slices to dentin. The physicochemical properties of the configured SPU adhesives were profiled for polymerization behavior, water contact angle, and tensile strain and strength. The bonding effectiveness was assessed through micro-tensile strength, nano-leakage tests conducted on the bonded samples before and after thermal cycle aging. Finally, we further conducted in vivo and in vitro experiments to assess the biocompatibility of adhesives. The results showed that the siloxane groups of SPU monomer could covalently bind to dentin collagen and hydroxyapatite. The incorporation of SPU in the adhesive led to a significant increase in adhesive polymerization (P < 0.05) and tensile strain at break up to 134.11%. Furthermore, the SPU adhesive significantly improved dentin bond strength (P < 0.05), reduced interfacial nano-leakage (P < 0.05), and displayed good biocompatibility. In conclusion, the application of SPU, which achieves dual chemical bonding with dentin, can improve the quality of the hybrid layer, buffer the interfacial stresses, enhance the interfacial resistance to hydrolysis, and provide a feasible strategy to extend the service life of adhesive restorations.

Characterization of dental light-curing resin composites incorporating multiple modified low-shrink monomers.

OBJECTIVE: Polymerization shrinkage poses a significant challenge in dental resin composites. The objective of this study is to introduce spiroorthocarbonate monomer 3,9-dimethylene-1,3,5,7-tetraoxa-spiro[5,5]undecane (BMSOC) and epoxy resin monomer 3,4-epoxycyclohexylmethyl-3,4-epoxycyclohexane carboxylate (ECHM-ECHC) into bisphenol-S-bis(3-methacrylato-2-hydroxy propyl)ether (BisS-GMA) based resin composites to develop composites with reduced shrinkage properties. METHODS: BMSOC and BisS-GMA were synthesized and thoroughly mixed with ECHM-ECHC, followed by inorganic fillers and photoinitiators. Based on the composition of the resin matrix, five groups of experimental composites were prepared, with traditional bisphenol A-dimethacrylate glycidyl ester (Bis-GMA)/triethylene glycol dimethacrylate (TEGDMA) based composite serving as the control. The polymerization properties, including degree of conversion (DC) and polymerization shrinkage (PS), as well as marginal microleakage, wettability, flexural strength (FS), flexural modulus (FM), and biocompatibility were evaluated. RESULTS: The results demonstrated that compared with the control group, the PS of BisS-GMA based composites containing BMSOC and ECHM-ECHC were significantly reduced (P < 0.05), and the lowest PS (0.96 ± 0.08 %) was observed when the ratio of BisS-GMA: (Epoxy + BMSOC) was 4:6. Additionally, the experimental composites also exhibited improved DC, minimal microleakage, low hydrophilicity, enhanced mechanical properties, qualified in vivo biocompatibility, and slight/moderate in vitro biocompatibility. SIGNIFICANCE: The resin composites incorporating multiple modified low-shrink monomers are promising for dental applications to prevent various clinical problems caused by PS and extend restoration longevity.

A comparative study on the mechanical and antibacterial properties of BPA-free dental resin composites.

OBJECTIVE: The commonly used base monomer utilized in resinous commercial dental restorative products is bis-GMA which is derived from bisphenol-A (BPA) - a well-known compound which may disrupt endocrine functions. To address concerns about its leaching into the oral environment and to optimize the quality of dental composites, a BPA-free alternative base monomer, fluorinated urethane dimethacrylate (FUDMA), was designed by modifying a UDMA monomer system. METHODS: Nine groups of composites were prepared by mixing the base monomers and TEGDMA in a ratio of 70/30 wt% to which were added silanized glass particles (mean diameter: 0.7 µm) in 3 different volume fractions (40, 45, and 50 vol%). Bis-GMA and UDMA base monomers were used as control groups in the same ratios. Various properties including degree of conversion (DC), flexural strength (FS) and flexural modulus (FM), water sorption (WS), solubility (SL), surface hardness and roughness, and initial adhesion property against S.mutans were investigated. One-way analysis of variance followed by Bonferroni test at α = 0.05 was used to analyze the results. RESULTS: A significant difference in FS between FUDMA-based composite with 40 vol% filler (120.3 ± 10.4 MPa) and Bis-GMA-based composite with the same filler fraction (105.8 ± 10.0 MPa) was observed but there was no significant difference among other groups. The UDMA based group exhibited the highest WS (1.3 ± 0.3 %). Bis-GMA showed greater initial bacterial adhesion but was not statistically different from the other groups (p = 0.082). SIGNIFICANCE: FUDMA-based resin composites exhibit comparable mechanical and bacterial adhesion properties compared with Bis-GMA and UDMA-based composites. The FUDMA composites show positive outcomes indicating they could be used as substitute composites to Bis-GMA-based composites.

Surface alterations and compound release from aligner attachments in vitro.

AIM: The aim of the present study was to assess the alterations in morphology, roughness, and composition of the surfaces of a conventional and a flowable composite attachment engaged with aligners, and to evaluate the release of resin monomers and their derivatives in an aqueous environment. METHODS: Zirconia tooth-arch frames (n = 20) and corresponding thermoformed PET-G aligners with bonded attachments comprising two composite materials (universal-C and flowable-F) were fabricated. The morphological features (stereomicroscopy), roughness (optical profilometry), and surface composition (ATR-FTIR) of the attachments were examined before and after immersion in water. To simulate intraoral use, the aligners were removed and re-seated to the frames four times per day for a 7-day immersion period. After testing, the eluents were analyzed by LC-MS/MS targeting the compounds Bis-GMA, UDMA, 2-HEMA, TEGDMA and BPA and by LC-HRMS for suspect screening of the leached dental material compounds and their degradation products. RESULTS: After testing, abrasion-induced defects were found on attachment surfaces such as scratches, marginal cracks, loss of surface texturing, and fractures. The morphological changes and debonding rate were greater in F. Comparisons (before-after testing) revealed a significantly lower Sc roughness parameter in F. The surface composition of the aligners after testing showed minor changes from the control, with insignificant differences in the degree of C = C conversion, except for few cases with strong evidence of hydrolytic degradation. Targeted analysis results revealed a significant difference in the compounds released between Days 1 and 7 in both materials. Insignificant differences were found when C was compared with F in both timeframes. Several degradation products were detected on Day 7, with a strong reduction in the concentration of the targeted compounds. CONCLUSIONS: The use of aligners affects the surface characteristics and degradation rate of composite attachments in an aqueous environment, releasing monomers, and monomer hydrolysates within 1-week simulated use.

Salivary levels of eluents during Invisalign™ treatment with attachments: an in vivo investigation.

BACKGROUND: The aim of the present study was to investigate qualitatively and quantitatively the elution of substances from polyester-urethane (Invisalign™) aligners and resin composite attachments (Tetric EvoFlow) in vivo. METHODS: Patients (n = 11) treated with the aligners and attachments (16 per patient, without other composite restorations) for an average of 20 months, who were planned for attachment removed were enrolled in the study. Patients were instructed to rinse with 50 mL of distilled water upon entry and the rinsing solution was collected (before removal). Then, the attachments were removed with low-speed tungsten carbide burs for adhesive residue removal, a thorough water rinsing was performed immediately after the grinding process to discard grinding particle residues, and subsequently, after a second water-rinsing the solution was collected for analysis (after removal). The rinsing solutions were analyzed for targeted (LC-MS/MS: Bis-GMA, DCDMA, UDMA, BPA) and untargeted (LC-HRMS: screening of leached species and their degradation products) compounds. RESULTS: Targeted analysis revealed a significant reduction in BPA after attachment removal (4 times lower). Bis-GMA, DCDMA, UDMA were below the detection limit before removal but were all detectable after removal with Bis-GMA and UDMA at quantifiable levels. Untargeted analysis reviled the presence of mono-methacrylate transformation products of Bis-GMA (Bis-GMA-M1) and UDMA (UDMA-M1), UDMA without methacrylate moieties (UDMA-M2), and 4-(dimethylamino) benzoic acid (DMAB), the degradation product of the photo-initiator ethyl-4-(dimethylamino) benzoate (EDMAB), all after attachment removal. Several amino acids and endogenous metabolites were also found both before and after removal. CONCLUSIONS: Elevated levels of BPA were traced instantaneously in patients treated with Invisalign™ and flowable resin composite attachments for the testing period. BPA was reduced after attachment removal, but residual monomers and resin degradation products were found after removal. Alternative resin formulations and attachment materials may be utilized to reduce eluents.

Achieving property enhancements in dental resin composites via reduced concentrations of camphorquinone within a ternary initiator system.

OBJECTIVES: The study aimed to assess the impact of diphenyliodonium hexafluorophosphate (DPI) on the physicochemical properties of experimental resin composites (ECRs) featuring reduced concentrations of camphorquinone (CQ)/amine. METHODS: Five concentrations of CQ (0.125, 0.25, 0.5, 0.75, and 1 mol%) with dimethylaminoethyl amine benzoate (EDAB) in a 1:2 mol% ratio (CQ:EDAB) were incorporated into a 50:50 mass% monomer blend of bisphenol glycidyl methacrylate (BisGMA) and triethyleneglycol dimethacrylate (TEGDMA). An additional 5 groups with the same CQ:EDAB concentrations had 0.5 mol% DPI added. Each resin group contained 60 wt% of 0.7 µm barium-alumino-silicate glass. Light transmission (n = 3), real-time degree of polymerization (n = 3), temperature change during polymerization (n = 5), polymerization shrinkage strain (n = 3), flexural strength, and modulus (n = 12), as well as water sorption and solubility (n = 5), were evaluated. Data were analyzed using two-way ANOVA and Tukey's post-hoc test (α = 0.05). RESULTS: Light transmission was reduced in groups containing 0.125 and 0.25 mol% of CQ without DPI. DPI increased temperature, degree and rate of polymerization, despite the reduction in CQ/amine concentration. Additionally, there was an increase in polymerization shrinkage strain, flexural strength and modulus, and a reduction in water sorption and solubility in ECRs with DPI, even with lower concentrations of CQ/EDAB. SIGNIFICANCE: DPI improved the assessed properties of composites across various concentrations of CQ/EDAB, showing the benefit of reducing the quantity of CQ used without compromising the properties and curing of the resin composites.

The effect of photoinitiator type and filler load on physicochemical and mechanical properties of experimental light-cured resin cements through lithium disilicate ceramics of different shades and thicknesses.

OBJECTIVE: This study investigated the influence of photoinitiator types on degree of conversion (DC), rate of polymerization (RP), flexural strength (FS), flexural modulus (FM), and light transmittance (LT) of filled and unfilled light-curable resin cements through different thicknesses and shades of lithium disilicate ceramics. METHODS: Lithium disilicate ceramic discs (IPS Emax Press, background [0.0], 0.5, 1.0, 2.0, 3.0, and 4.0 mm, shades A1 and BL3) were prepared. Experimental resin-based cements [TEGDMA/BisGMA (50/50 mass%)] were prepared using either camphorquinone (CQ)/amine (0.44/1.85 mol%) or TPO (0.44 mol%)], and a micro and nanofiller loads of nil (unfilled); 40/10 mass%; and 50/10 mass%). Resin cements (0.2 mm thick) were placed on the lower surface of the ceramic specimens and light-activated for 30 s from the upper surface using a Bluephase Style curing light (exitance at tip: 1236 mW/cm2 ± 1.20). LT and distribution of irradiance through the ceramics were measured using a UV-vis spectrometer and a beam profile camera, respectively (n = 3). The DC and RP were measured in real-time using mid infrared spectroscopy in attenuated total reflectance (ATR) mode (n = 3). FS and FM were measured using a universal testing machine (n = 5). Statistical analyses were performed on LT, DC, RP, FS, and FM data using a general linear model, and supplementary ANOVA and post hoc Tukey multiple comparison test were also performed (α = .05). RESULTS: Thicknesses, shades, photoinitiator type, and fillers load significantly influenced the optical and mechanical characteristics of the resin-based materials (p < 0.05). The BL3 shade ceramic provided higher values of DC, RP, FS, FM, and LT compared with the A1 shade (p < 0.05). Increasing ceramic thickness decreased the properties of the resin-based materials (p < 0.05). Generally, TPO improved mechanical properties of the resin cement compared with CQ (p < 0.05). SIGNIFICANCE: The luting process of indirect restorations may be improved by using high molar absorptivity, more reactive, and more efficient photoinitiators such as TPO, as opposed to conventional CQ. The use of such initiator may allow the placement of thicker and more opaque indirect restorations.

The chemical and optical stability evaluation of injectable restorative materials under wet challenge.

OBJECTIVES: To investigate and compare the chemical and optical stability of four restorative composite materials: two injectable resins, one flowable resin and one compomer. METHODS: Two injectable nano-filled composite resins: G-aenial Universal (GU) and Beautifil Injectable XSL (BI), a flowable composite resin: Filtek Supreme Flowable (FS) and a compomer: Dyract Flow (DF), in A2 shade were tested and compared. Water sorption and solubility were conducted according to ISO4049:2019 standard; ICP-OES and F-ion selective electrode were used to test the elemental release; Degree of conversion (DC) was obtained by using FTIR; water contact angle was obtained by static sessile drop method, and a spectrophotometer was used for optical properties (ΔE⁎, ΔL⁎ and TP). SPSS 28.0 was used for statistical analysis and the significant level was pre-set as α = 0.05. RESULTS: GU performed the best in water sorption and solubility, FS had the lowest elemental release, the best colour stability, and the highest DCIM and DC24-h. DF, the compomer had the lowest, and GU and BI, the injectable composites had the largest water contact angle, respectively. Correlations were found between water sorption and water solubility. CONCLUSIONS: The four composite restorative materials showed different chemical and optical behaviours. Overall, composite resins performed better than compomer, while additional laboratory and in vivo tests are necessary to obtain a more comprehensive comparison between injectable and flowable composite resins. Wsp and Wsl are influenced by many common factors, and the values are highly positively related. CLINICAL SIGNIFICANCE: A comprehensive understanding of materials is crucial before selecting materials for clinical practice. Composite resins rather than compomers are recommended because of their exceptional properties, which make them eligible for a wide range of clinical applications and an elongated lifespan.

Evaluating flexure properties, hardness, roughness and microleakage of high-strength injectable dental composite: an in vitro study.

BACKGROUND: Recently, a new generation of high-strength flowable dental composites has been introduced by manufacturers. The manufacturers claim that these materials have enhanced mechanical and physical properties and are suitable for use in a wide range of direct anterior and posterior restorations, even in high-stress bearing areas. AIM: The objective of this study was to assess certain physical and mechanical properties of these recently introduced high-strength flowable composites in comparison to conventional multipurpose dental composites. METHODS: Four types of high-strength flowable composites (Genial Universal FLO, Gaenial Universal Injectable, Beautifil Injectable, and Beautifil Flow Plus) were tested in experimental groups, while a nanohybrid conventional composite (Filtek Z350 XT) was used as the control. For flexure properties, ten rectangular samples (2 × 2 × 25 mm) were prepared from each composite material and subjected to 5000 cycles of thermocycling. Samples were then subjected to flexural strength testing using the universal testing machine. Another twenty disc-shaped specimens of dimensions (5 mm diameter × 2 mm thickness) were fabricated from each composite material for surface roughness (Ra) (n = 10) and hardness (VHN) test (n = 10). All samples underwent 5000 cycles of thermocycling before testing. Additionally, microleakage testing was conducted on 60 standardized class V cavities prepared on molar teeth and divided randomly into five groups (n = 12). Cavities were then filled with composite according to the manufacturer's instructions and subjected to thermocycling for 1000 cycles before testing using methylene blue solution and a stereomicroscope. RESULTS: All tested materials were comparable to the control group in terms of flexural strength and surface roughness (p > 0.05), with Gaenial Universal FLO exhibiting significantly higher flexural strength compared to the other flowable composite materials tested. However, all tested materials demonstrated significantly lower elastic modulus and surface hardness than the control group (p < 0.05). The control group exhibited higher microleakage scores, while the lowest scores were observed in the Gaenial Universal FLO material (p < 0.05) CONCLUSION: The physical and mechanical behaviors of the different high-strength flowable composites investigated in this study varied. Some of these materials may serve as suitable alternatives to conventional composites in specific applications, emphasizing the importance of dentists being familiar with material properties before making material selections.

Clinical evaluation of Giomer and self-etch adhesive compared with nanofilled resin composite and etch-and-rinse adhesive - Results at 8 years.

OBJECTIVE: This study aimed to evaluate the long-term clinical performance of Giomer and a self-etch adhesive system compared with a nanofilled resin composite and etch-and-rinse adhesive system in Class I and Class II restorations. METHOD: The study was designed to be double-blinded with intra-individual control. 48 patients with 54 pairs of cavities (class I or class II) were recruited. Each pair of restorations was placed with either BEAUTIFIL II (BF) and FL-BOND II (FL) or Filtek Z350 (Z350) and Scotchbond Multi-Purpose (SMP). Clinical evaluation was performed at baseline, 6-month, 18-month, 4-year and 8-year after placement according to modified USPHS criteria. Kaplan-Meier survival analysis and log rank tests were performed (SPSS 20.0, IBM Corporation, US) to compare the survival probability of different restorations.A generalized linear mixed model (GLMM) was adopted to assess the performance of the materials. The McNemar test was used to show significant changes for all the evaluation criteria and difference between them. RESULTS: At the eight-year recall, 32 patients with 67 restorations were present. There were twelve restorations in total recorded as failure due to loss of retention, restoration fracture, secondary caries, tooth fracture or endodontic treatment due to pulp necrosis. The survival probabilities and calculated annual failure rate(AFR) of BF and Z350 restorations at 8-year were 87.2 % vs 87.8 % and 1.6 % vs 1.5 % respectively with no significant difference (p > 0.05)between the two materials. Over the recall time range of eight years, decreased possibility of alpha rating was observed for retention, marginal adaptation, marginal staining and surface roughness for both materials (p < 0.05). Decreased possibility of alpha rating was observed for surface staining and secondary caries for Z350 (p < 0.05) and restoration fracture for BF (p < 0.05), respectively. Comparing the two restorative systems over eight years, no significant difference was seen for linear decline of the possibility of alpha rating for any of the criteria evaluated (p > 0.05). CONCLUSION: Giomer material and the self-etch adhesive system had comparable clinical performance with nanofilled resin composite and etch-and-rinse adhesive system over the observation period of eight years.